Not mandatory

Intrauterine contraceptive devices (IUDs) are highly efficient at preventing unintended pregnancies, without minimal failure rates, rare complications such as retention or displacement during pregnancy may lead to significant clinical challenge. This case discusses the diagnostic and management challenges of presumed IUD retention in the background of poor antenatal care. Multigravida woman, GIII/PII/A0, 24 years old with two previous caesarean deliveries, admitted in active labor at term. She received no antenatal care for her pregnancy because she could not afford it, and she thought that, because she had an IUD placed after her last cesarean section, she was infertile. On examination, uterine fundal height was 34 cm, amniotic membranes were intact, and the cervix was fully dilated as labor progressed. Spontaneous vaginal delivery was achieved and a 4050-gram (9 lb) neonate was delivered with Apgar scores of 4 at one minute and 5 at five minutes. In the postpartum period, she experienced complications including retained placenta requiring manual extraction and an estimated blood loss of 250 mL. After complete exploration and subsequent imaging, the IUD was not visualized, suggesting either early expulsion, unnoticed displacement or misplacement occurred at insertion. The patient’s postpartum course was unremarkable with appropriate uterotonic therapy and close observation. This case highlights the need for full antenatal care to prevent and manage complications associated with IUDs including displacement or retention that may result in adverse maternal and fetal outcomes. Timely diagnosis and early interventions coupled with appropriate imaging and clinical follow-up services are essential to optimize outcomes and minimize associated risks.

Background: Tuberculosis (TB) and Diabetes Mellitus (DM) are global problems, especially in countries with high TB endemicity. The relationship between TB and DM is more dominant in developing countries where TB is endemic, and the prevalence of DM is increasing. The risk of death during TB treatment and the risk of relapse after treatment is higher in TB patients with comorbid DM. More than 10% of TB patients are also known to have DM. This study aims to determine the epidemiological picture of TB-DM incidence based on time, place and person. Methods: This study uses a descriptive quantitative design with a case study approach; the analysis used is univariate analysis using proportions. The population of TB-DM patients in 2021-2023 was recorded in medical records, with a purposive sampling technique obtained from 110 people. Results: The epidemiological picture of TB-DM cases based on the characteristics of the person is age = 45 years (80.9%), male gender (71.8%), type of pulmonary TB (98.2%), bacteriologically confirmed TB diagnosis (73.6%), the final result of TB treatment is cured (52.7%), type of DM therapy is insulin injection (76.4%) and high random blood sugar levels > 200 mg/dL (64.5%). Conclusions: The epidemiological picture of TB-DM cases for three years (2021-2023) has an upward trend and the highest cases in 2022; the majority of TB-DM cases are male, aged > 45 years, with the most cases coming from Bantul Regency.

Background: Early detection of non-communicable diseases (NCDs) through integrated guidance posts (Posbindu PTM) can be enhanced through mobile health applications. This study aimed to develop and evaluate the usability of Sembada m-Health, an Android-based application for conducting Posbindu PTM activities at Sleman Regional General Hospital. Methods: This Research and Development study employed the Four D model (Define, Design, Develop, Disseminate). The define phase involved stakeholder needs assessment through Focus Group Discussions. The design phase encompassed application development by IT experts, while the develop phase included multi-level testing by material experts (n=2), media experts (n=2), and end-users (n=30). Structured questionnaires assessed media and material aspects, while the Post-Study System Usability Questionnaire (PSSUQ) evaluated user experience. The disseminate phase included application socialization and qualitative evaluation. The study was conducted in Yogyakarta from October 2021 to April 2022, with feasibility thresholds set at =4.20 for media and material aspects and =2.82 for PSSUQ. Results: The application exceeded all feasibility thresholds, scoring 4.62 for media aspects, 4.23 for material aspects, and 1.71 on the PSSUQ. Stakeholders expressed high satisfaction with Sembada m-Health system functionality, particularly its support for individual health monitoring, program implementation, NCD risk factor tracking, and personalized recommendations. Conclusions: Sembada m-Health demonstrated high usability and feasibility for supporting the Posbindu PTM program. Future research should focus on evaluating its long-term impact on NCD prevention and management outcomes.

Background: Among the various methods, drugs, strategies, and guidelines for optimal anesthesia selection, the anesthesia and critical care staff primarily aim to choose the anesthetic with the least risk to the patient. Spinal anesthesia is one of the most effective and commonly used forms of anesthetic for hernia repair procedures. This study aims to provide an updated and accurate analysis of patients undergoing hernia repair at Karbala Al-Hassan Hospital and Al-Hussein Medical City. Methods: We divided 100 patients who underwent herniotomy into two groups based on the type of anesthesia received: 50 patients received spinal anesthesia (SA), and 50 received general anesthesia (GA). The analysis included patient age, weight, changes in blood pressure, and pulse rate. To ensure comprehensive monitoring, patients aged 20 to 90 years were followed before, during, and after the procedure. Results: The results indicate greater hemodynamic stability in patients who received SA, with approximately 56% of patients demonstrating stable parameters compared to 40% in the GA group. However, higher blood pressure was observed more frequently in the GA group (32%) compared to the SA group (24%). Similarly, lower blood pressure was more common in GA (28%) than in SA (20%). Heart rate analysis revealed that SA resulted in greater stability, with 56% of patients maintaining a stable heart rate, compared to 32% in the GA group. Conversely, an increased heart rate was observed in 34% of patients in the SA group compared to 60% in the GA group. A decreased heart rate was reported in 10% of SA patients and 8% of GA patients, further supporting the conclusion that SA provides more stable outcomes. Conclusions: Spinal anesthesia was found to be superior to general anesthesia in maintaining heart rate and blood pressure stability at normal or minimally fluctuating levels.

Background: In Indonesia, the prevalence of stunting remains a pressing issue, with rates still considerably high and far from achieving the national target of 14%. One of the critical strategies in addressing this problem is providing adequate education and information to brides-to-be (Catin) regarding pregnancy planning and childcare as a preventive measure against stunting. This study aims to analyze the impact of stunting prevention health counseling using animated video media on improving the knowledge of brides-to-be. Methods: The study involved 60 brides-to-be attending counseling sessions at the BKKBN KB Counseling Center in Rajabasa District, South Lampung Regency. A pre-test and post-test design was utilized to measure changes in knowledge levels. Results: The results showed that prior to the intervention, 25 participants (41.7%) demonstrated good knowledge about stunting prevention. Following the counseling sessions, this number increased significantly to 58 participants (96.7%). Statistical analysis revealed a p-value of 0.0001 (p < 0.05), confirming a significant effect of the intervention. Conclusions: The study highlights the effectiveness of animated video media in delivering health education due to its ability to present information in an engaging, visual, and emotional format. This approach not only enhances comprehension but also sustains interest, making it a valuable tool for increasing awareness and knowledge about stunting prevention among brides-to-be. Strengthening such initiatives can contribute significantly to achieving the national stunting reduction target in Indonesia.